Methods and systems for improving infection control in a facility

ABSTRACT

Methods and systems for monitoring procedural compliance of staff in a facility. A system may include a plurality of sensors positioned adjacent a hand washing station. Each of the plurality of sensors may be configured to provide a corresponding sensor output signal that is indicative of whether a person is washing their hands at the hand washing station or not. A controller may be configured to fuse the sensor output signals from each of two or more of the plurality of sensors and to determine using the fused sensor output signals whether the person has washed their hands at the hand washing station in compliance with one or more predetermined criteria or not. The controller may be further configured to output a notification when the controller has determined that the person has washed their hands at the hand washing station in compliance with the one or more predetermined criteria.

CROSS-REFERENCE TO RELATED APPLICATIONS

This is a continuation of co-pending U.S. patent application Ser. No.16/561,709, filed Sep. 5, 2019, which claims the benefit under 35 U.S.C.§ 119(e) of U.S. Provisional Application No. 62/727,480, filed Sep. 5,2018, both of which are incorporated herein by reference.

TECHNICAL FIELD

The disclosure generally relates to procedural compliance of staff in amedical treatment facility, and more particularly to systems and methodsfor monitoring and/or correcting procedural compliance of staff in amedical treatment facility to reduce the risk of Hospital AcquiredInfections (HAI).

BACKGROUND

Hospital Acquired Infections (HAI) and/or Surgical Site Infections (SSI) are infections caused by virus, bacteria and other environmentalfactors acquired within hospitals or other medical treatment facilities.It is estimated that HAI and SSI infections cost the healthcare industrynearly $40 billion annually. HAI and SSI infections can be transmittedin multiple ways, including, but not limited to, surface contamination,airborne particulates and aspiration. HAI and SSI infections can bereduced by following strict procedures, including procedures regardingdecontamination practices, hand-hygiene/antisepsis procedures, and otherprocedures. However, rather low compliance with such procedures amongstaff have been reported.

Hand-hygiene compliance monitoring systems can be utilized in homes,daycares, schools, restaurants, health care facilities includinghospitals. In some cases, hand washing compliance is a metric thathospitals and other facilities would be interested in tracking andreporting. Currently, there are several methods of gathering handwashing compliance data. These methods are often ineffective,inaccurate, costly, and/or hard to install and maintain. For example,the secret shopper method is one of the most common methods of gatheringhand washing compliance data. In the secret shopper method, personnelare hired to periodically monitor hand-hygiene compliance of staff. Thismethod can be inaccurate due to human error and the presence of amonitoring person can modify staff behavior. Another prevalent method isa real time location system (RTLS) approach where staff are trackedthrough an infrastructure of location beacons and anchors. This system,aside from being expensive, can be inaccurate, as the system onlyensures that the staff person has passed through the vicinity of awashing station, but not that they actually washed their hands.

What would be desirable is a method and system to help improvecompliance with infection control procedures such as hand-hygienecompliance.

SUMMARY

This disclosure relates to procedural compliance of staff in a medicaltreatment facility, and more particularly to systems and methods formonitoring and/or correcting procedural compliance of staff in a medicaltreatment facility to reduce the risk of Hospital Acquired Infections(HAI).

For instance, in one example, a hand-hygiene monitor may be providedthat includes an accelerometer to detect vibration within a first range,a microphone to detect sound within a second range, and a transmitelement to transmit data detected by the accelerometer and themicrophone. Additionally, or alternatively, the hand-hygiene monitor caninclude one or more additional sensors. For example, the hand-hygienemonitor can include, but is not limited to, a light sensor, a radar, ahumidity sensor, a temperature sensor, a motion detector, amagnetometer, or a combination thereof. The additional sensors canprovide additional data and/or increase accuracy of the hand washingcompliance data.

In some examples, the hand-hygiene monitor may be included in a system.The system may also include a processor, which may receive the data fromthe hand-hygiene monitor. The processor can, for example, be configuredto determine whether a person has washed their hands by analyzing datafrom the hand-hygiene monitor. In some embodiments, the processor canuse a machine learning model to improve the accuracy of the system overtime. In some embodiments, the processor can be included in a cloudserver.

The system may also include a tracking device. The tracking device maybe included in an identification card, for example. In some examples,the tracking device may be used in combination with the data from thehand-hygiene monitor to identify the person, the person's location,and/or whether or not they are in compliance with washing their hands.

In a first example, a system for monitoring hand-hygiene of staff in afacility may comprise a plurality of sensors positioned adjacent a handwashing station. Each of the plurality of sensors may be free fromimaging pixels that form a visually perceptible image of the handwashing station. Each of the plurality of sensors is configured toprovide a corresponding sensor output signal that is indicative ofwhether a person is washing their hands at the hand washing station ornot, and at least two of the plurality of sensors are of a differentsensor type. A controller may be configured to fuse the sensor outputsignals from each of two or more of the plurality of sensors and todetermine using the fused sensor output signals whether the person haswashed their hands at the hand washing station in compliance with one ormore predetermined criteria or not. The controller may be furtherconfigured to output a notification when the controller has determinedthat the person has washed their hands at the hand washing station incompliance with the one or more predetermined criteria.

In some cases, the plurality of sensors may comprise an accelerometerand/or a microphone, and optionally one or more of a light sensor, aradar sensor, a humidity sensor, a temperature sensor, a motiondetector, and/or a magnetometer. In some cases, the controller may fusethe sensor output signals from the accelerometer and the microphone.

In some cases, the one or more predetermined criteria may comprise twoor more distinct hand washing steps which may include a hand scrubbingstep and a dispensing of soap step. The two or more distinct handwashing steps may also comprise approaching the hand washing station,dispensing of soap at the hand washing station, hand scrubbing at thehand washing station, and departing from the hand washing station.

In some cases, the controller may be further configured to identify andrecord an identity of the person washing their hands at the hand washingstation, and whether the hand washing was in compliance with the one ormore predetermined criteria.

In some cases, the system may further comprise an RFID reader forreading an RFID tag carried by the person. The controller may beoperatively connected to the RFID reader and may be configured toidentify the person washing their hands based on the RFID tag read bythe RFID reader.

In some cases, the controller may be configured to determine if the handscrubbing step lasted at least a minimum duration of time with at leasta minimum level of vigor.

In another example, a system for monitoring hand-hygiene of staff in afacility may comprise a plurality of sensors positioned adjacent a handwashing station including an accelerometer and a microphone. Each of theplurality of sensors may be configured to provide a corresponding sensoroutput signal that is indicative of whether a person is washing theirhands at the hand washing station or not. A controller may be configuredto use the sensor output signals from the accelerometer and themicrophone to determine whether the person has washed their hands at thehand washing station in compliance with one or more predeterminedcriteria or not. The controller may be further configured to output anotification when the controller has determined that the person haswashed their hands at the hand washing station in compliance with theone or more predetermined criteria.

In some cases, the plurality of sensors may further comprise one or moreadditional sensors. The one or more additional sensors may comprise oneor more of a light sensor, a radar sensor, a humidity sensor, atemperature sensor, a motion detector, and/or a magnetometer. Thecontroller may be configured to use the sensor output signals from oneor more of the additional sensors to determine whether the person haswashed their hands at the hand washing station in compliance with theone or more predetermined criteria.

In some cases, the controller may be configured to fuse the sensoroutput signals from the accelerometer, the microphone and one or more ofthe additional sensors to determine whether the person has washed theirhands at the hand washing station in compliance with the one or morepredetermined criteria or not.

In some cases, the one or more predetermined criteria may comprise twoor more distinct hand washing steps. The two or more distinct handwashing steps may comprise a hand scrubbing step and a dispensing ofsoap step.

In another example, a method for monitoring hand-hygiene of staff in afacility may comprise determining whether a person has washed theirhands at a hand washing station in compliance with one or morepredetermined criteria or not using two or more sensor outputs from twoor more sensors positioned adjacent the hand washing station. Each ofthe two or more sensors may be free from imaging pixels that form avisually perceptible image of the hand washing station. At least two ofthe two or more sensors are of a different sensor type. The one or morepredetermined criteria may comprise two or more distinct hand washingsteps including a dispensing of soap step and a hand scrubbing step. Themethod may further comprise reporting whether the person has washedtheir hands at the hand washing station in compliance with the one ormore predetermined criteria.

In some cases, the two or more sensors may comprise an accelerometerand/or a microphone, and one or more of a light sensor, a radar sensor,a humidity sensor, a temperature sensor, a motion detector, and/or amagnetometer.

In some cases, the method may further comprise fusing two or more sensoroutputs from the two or more sensors to increase a confidence level inthe determination of whether the person has washed their hands at thehand washing station in compliance with the one or more predeterminedcriteria or not.

In some cases, the method may further comprise determining whether thetwo or more distinct hand washing steps occurred in a predeterminedorder and/or whether one or more of the two or more distinct handwashing steps lasted for at least a predetermined time period.

The preceding summary is provided to facilitate an understanding of someof the features of the present disclosure and is not intended to be afull description. A full appreciation of the disclosure can be gained bytaking the entire specification, claims, drawings, and abstract as awhole.

BRIEF DESCRIPTION OF THE DRAWINGS

The disclosure may be more completely understood in consideration of thefollowing detailed description of various embodiments in connection withthe accompanying drawings, in which:

FIG. 1 is a schematic block diagram of an illustrative system formonitoring procedural compliance of staff in a facility;

FIG. 2 is a flow chart of an illustrative method for monitoringprocedural compliance of staff in a facility;

FIG. 3 is a schematic block diagram of an example hand-hygiene monitorthat can be utilized according to one or more embodiments of the presentdisclosure;

FIG. 4 is a schematic view of a hand washing station in a facilityincluding an illustrative system for monitoring hand washing complianceof staff in a facility; and

FIG. 5 is a flow chart of an illustrative method for monitoringprocedural compliance of staff in a facility.

While the disclosure is amenable to various modifications andalternative forms, specifics thereof have been shown by way of examplein the drawings and will be described in detail. It should beunderstood, however, that the intention is not to limit aspects of thedisclosure to the particular embodiments described. On the contrary, theintention is to cover all modifications, equivalents, and alternativesfalling within the spirit and scope of the disclosure.

DESCRIPTION

The following detailed description should be read with reference to thedrawings in which similar elements in different drawings are numberedthe same. The detailed description and the drawings, which are notnecessarily to scale, depict illustrative embodiments and are notintended to limit the scope of the disclosure. The illustrativeembodiments depicted are intended only as exemplary. Selected featuresof any illustrative embodiment may be incorporated into an additionalembodiment unless clearly stated to the contrary.

These embodiments are described in sufficient detail to enable those ofordinary skill in the art to practice one or more embodiments of thisdisclosure. It is to be understood that other embodiments may beutilized and that process changes may be made without departing from thescope of the present disclosure.

As will be appreciated, elements shown in the various embodiments hereincan be added, exchanged, combined, and/or eliminated so as to provide anumber of additional embodiments of the present disclosure. Theproportion and the relative scale of the elements provided in thefigures are intended to illustrate the embodiments of the presentdisclosure and should not be taken in a limiting sense.

As used herein, “a” or “a number of” something can refer to one or moresuch things. For example, “a number of devices” can refer to one or moredevices.

Hospital Acquired Infections (HAI) and/or Surgical Site Infections (SSI) are infections caused by virus, bacteria and other environmentalfactors acquired within hospitals or other medical treatment facilities.HAI and SSI infections can be transmitted in multiple ways, including,but not limited to, surface contamination, airborne particulates andaspiration. HAI and SSI infections can be reduced by following strictprocedures, including procedures regarding decontamination practices,hand-hygiene/antisepsis procedures, and other procedures. This mayinclude, but not limited to, operating room personnel, physicians,nursing staff, custodial staff, etc. However, rather low compliance tosuch procedures among staff have been reported.

One example of a procedure where compliance can be important is in anoperating room (OR). In the case of an OR, all sterile team membersshould perform a hand and arm scrub before entering the surgical suite.The basic principle of the scrub is to wash the hands thoroughly, andthen to wash from a clean area (the hand) to a less clean area (thearm). A systematic approach to the scrub is an efficient way to ensureproper technique. There are typically two methods of scrub procedure.One is a numbered stroke method, in which a certain number of brushstrokes are designated for each finger, palm, back of hand, and arm. Analternative method is a timed scrub, and each scrub should last fromthree to five minutes, depending on facility protocol.

This disclosure generally relates to method and systems for monitoringprocedural compliance of staff in a facility such as hand-hygienecompliance, while maintaining patient and/or staff privacy, and forproviding real time notification to the staff when a procedure isperformed incorrectly or not at all. In one example, the presentdisclosure discloses methods, devices, systems, and computer-readablemedia useful for monitoring hand-hygiene. In some instances,hand-hygiene compliance data is gathered using a hand-hygiene monitor.The hand-hygiene monitor may include distributed synthetic sensors thatare minimally obtrusive to detect and alert hand-hygiene incidents. Thesensors may be placed so that a lapse in handwashing procedures can bepositively identified and alerted. The sensors used may include, forexample, microphones, accelerometers, ambient light, and/or othersensors. In some cases, such sensors may be used in conjunction withedge analytics to detect a faucet open and hand washing events. In somecases, a radiofrequency (RF) radar based sensor maybe used to detect thepresence of a person at a hand washing station, and in some instances, ahand washing motion of the hands. Fusion of the results of varioussensing modalities may help identify hand washing compliance withgreater certainty, while maintaining patient and/or staff privacy (e.g.free from imaging pixels that together can be used to form a visuallyperceptible image of the hand washing station). While the system isdescribed with respect to a medical facility, it is contemplated thatthe system may be used in other environments to ensure proceduralcompliance, such as, but not limited to, senior care facilities, nursinghomes, restaurants, hotels, office buildings, etc.

FIG. 1 is a schematic block diagram of an illustrative system 10 formonitoring procedural compliance (e.g., hand washing or hand-hygiene) ofstaff in a hospital or other clinical setting. The illustrative system10 may determine if a person has washed their hands at a hand washingstation in compliance with one or more predetermined criteria. Thedetermination may be made without the use of cameras that have imagingpixels that output a visually perceptible image of the hand washingstation. In some cases, the system 10 may be configured to use syntheticsensors that are minimally obtrusive to detect and alert hand-hygieneincidents. Generally, the system 10 may include a hand-hygiene monitor12 and a computing device 14. In some cases, the information processingmay be performed at the hand-hygiene monitor 12 and a separate computingdevice 14 may not be required. In some instances, the system 10 mayinclude a wearable device 56 (e.g., a watch, a bracelet, a fitnesstracker, an identification badge, etc.), a user device 58 (e.g., a cellphone, a tablet computer, etc.) carried by the person entering the room,and/or a tracking device 62, but these are not required in all cases.

In some cases, the hand-hygiene monitor 12 may be a separate system thatis placed in a particular area (e.g., near a hand washing station) orworn by a person as an identification card, a smart phone, or a wearable(e.g., pendant, smart watch, smart glasses, etc.), for example. Whenworn by a person, some or part of the hand-hygiene monitor 12 may beworn on both wrist and/or both hands. For example, some or part of thehand-hygiene monitor 12 may be incorporated into a watch, bracelet,ring, etc. and may be worn on one arm/hand or both arms/hands.

The illustrative hand-hygiene monitor 12 may include a communicationsport 26 for operatively coupling to a computing device 14, a wearabledevice 56, a user device 58, and/or a tracking device 62 when present.It is contemplated that the communications port 26 may be wired and/orwireless. When the communications port 26 is wireless, thecommunications port 26 may include a wireless transceiver, and thecomputing device 14, the wearable device 56, the user device 58, and/orthe tracking device 62 may include a compatible wireless transceiver. Itis contemplated that the wireless transceivers may communicate using astandard and/or a proprietary communication protocol. Suitable standardwireless protocols may include, for example, cellular communication,ZigBee, Bluetooth, WiFi, IrDA, dedicated short range communication(DSRC), EnOcean, or any other suitable wireless protocols, as desired.

The hand-hygiene monitor 12 may include one or more controllers orprocessors 24 that execute instructions stored in the system memory 28.In some cases, the controller 24 may include a programmablemicroprocessor. Such a programmable microprocessor may allow a user tomodify the control logic of the hand-hygiene monitor 12 even after it isinstalled in the field (e.g., firmware update, application update). Thesystem memory 28 of the hand-hygiene monitor 12 can include computersystem readable media in the form of volatile memory, such as randomaccess memory (RAM) and/or cache memory. The hand-hygiene monitor 12 mayfurther include other removable/non-removable, volatile/non-volatilecomputer system storage media. By way of example only, the storagesystem can be provided for reading from and writing to a non-removable,non-volatile magnetic media (not shown and typically called a “harddrive” or flash memory). The system controller 24 and/or memory 28 mayinclude at least one program/utility having a set of program modulesthat are configured to receive an input from or transmit an output to aremote computing device 14, a wearable device 56, a user device 58,and/or a tracking device 62.

In one example, the program/utility may be stored in the system memory28 and may include one or more application program modules (e.g.,software), such as a procedural compliance module 30. The proceduralcompliance module 30 may define one or more hand washing procedures thatshould be performed in a particular room of a facility in order toreduce the risk of infection. Each defined procedure may include onemore predefined criteria, conditions, or actions that should be taken inorder for the procedure to have been considered as performed correctlyor to a set standard, as will be described in more detail herein. It iscontemplated that the defined procedures may be different for differenttypes of rooms and/or a category type of the person entering the room.For example, the defined procedures for an Operating Room (OR) may bedifferent than the defined procedures for a patient room. In some cases,the procedural compliance module 30 may be a part of the hand-hygienemonitor 12 or may be executed on the remote computing device 14, as willbe described in more detail herein.

The illustrative hand-hygiene monitor 12 may include a plurality ofsensors 16. In some instances, the plurality of sensors 16 may worktogether to provide a synthetic sensor. A synthetic sensor can beconsidered a plurality of sensors that sense different conditions withinan environment (e.g., motion, humidity, vibration, etc.), and where thedifferent sensed conditions are fused to detect certain actions orconditions. A plurality of sensors 16 may be positioned adjacent to ahand washing station. In some embodiments, the hand-hygiene monitor 12may include at least two sensors with at least two different sensortypes. In some implementations, the plurality of sensors 16 of thehand-hygiene monitor 12 may include at least an accelerometer 18 and amicrophone 20, an accelerometer 18 and a radar 54, and/or a microphone20 and a radar 54. These are just some examples. The hand-hygienemonitor 12 may include additional sensors as well, including, but notlimited to a light sensor 44, a humidity sensor 46, a temperature sensor48, a magnetometer 50, a motion detector 52, etc. or a combinationthereof. To help protect patient and staff privacy, it is contemplatedthat each of the sensors 16 may be free from imaging pixels that form avisually perceptible image of the hand washing station and/orsurrounding area. As will be described in more detail herein, eachsensor of the plurality of sensors 16 may provide a corresponding sensoroutput signal that is indicative of whether a person is washing theirhands at the hand washing station or not. For example, the sensor outputsignal for an accelerometer 18 fixed to the sink of the hand washingstation may collect a vibration signature that is indicative of runningwater, a vibration signature that is indicative of hand washing underrunning water, etc. The sensor output signal for an accelerometer 18fixed to a bracelet of the staff member may collect a motion signaturethat signifies that the person is moving their hand(s) in a hand washingmotion. In another example, the sensor output signal for the microphone20 may collect a sound signature that is indicative of running waterand/or hand washing under running water. In yet another example, thesensor output signal for the radar 54 may collect a radar signature thatis indicative of running water and/or hand washing under running water.The sensor output signal for the humidity sensor 46 may detect anincrease in humidity that is indicative of running water and/or handwashing under running water. When such sensor output signals are fusedtogether, sometimes with various weighting factors, compliance with aset hand washing procedure may be detected with greater certainty, whileprotecting patient and/or staff privacy. That is, the controller 24and/or procedural compliance module 30 may use the fused sensor signaloutput to determine whether the person has washed their hands at thehand washing station in compliance with one or more predeterminedcriteria or not. It contemplated that the controller 24 and/orprocedural compliance module 30 may be configured to output anotification when the controller 24 and/or procedural compliance module30 has determined that the person has washed their hands at the handwashing station in compliance with the one or more predeterminedcriteria and/or when the person has not washed their hands at the handwashing station in compliance with the one or more predeterminedcriteria.

In one specific example, when the accelerometer 18 is fixed to the sinkbase, the accelerometer 18 can detect water flow. As water flows fromthe faucet and contacts the sink base, the accelerometer 18 can detectthe vibrations generated by the flowing water. Thus, the accelerometer18 can determine whether the faucet is running based on the vibrationthe faucet creates when the faucet is on and allowing water to flow. Itis further contemplated that the accelerometer 18 can also detect whenhands are interrupting the flow of water. For example, when hands areinterrupting the water flow, different vibration signature may beproduced than when the water is flowing uninterrupted from the faucet tothe sink basin. In some cases, the accelerometer 18 may discern adifference between a person holding their hand(s) stationary under theflow of water and making a scrubbing motion with their hands under theflow of water. This can be discerned because the scrubbing motioncreates a different vibration signature at the accelerometer 18 thanholding one or both hands stationary under the faucet.

In some embodiments, the accelerometer 18 and/or the processor 24 mayalso record how long the faucet was running and/or how long the personwas washing their hands based on the length of the various detectedvibration signatures. In some examples, a person could be deemednoncompliant with hand washing procedures when the person did notactively wash their hands for at least a minimum period of time. Thevibration signature of the faucet running and/or the vibration signatureof hands interrupting the flow of water can be used to determine whethera person washed their hands for at least the minimum period of timenecessary to be compliant with the defined hand washing procedures. Insome examples, the accelerometer 18 may also detect the vibration due tosoap dispensing, a hand dryer blowing, a person drying their hands, or apaper towel dispensing, for example. Similar to the faucet, theaccelerometer 18 can detect vibration signatures that are unique to eachof these actions.

As detailed further herein, other sensor outputs (e.g. microphone 20,light sensor 44, humidity sensor 46, temperature sensor 48, magnetometer50, motion detector 52 and radar 54) may be fused with the accelerometeroutput to increase the certainty of the compliance decision. In somecases, each of the following actions or steps may be detected using theaccelerometer 18:

1) water flowing from a faucet into a sink basin with no interference;

2) soap dispensing;

3) water flowing from a faucet into a sink basin with stationary handspositioned within the water flow;

4) water flowing from a faucet into a sink basin with moving hands(e.g., scrubbing) positioned within the water flow;

5) a hand dryer blowing;

6) a person drying their hands in a hand dryer; and

7) a paper towel dispensing.

The preceding list of actions and/or steps of a handwashing procedure(compliant or otherwise) is not intended to be inclusive of all actionsand/or steps that can be used to determine if a handwashing procedure iscompliant or not, but rather indicative of some of the types of actionsthat can be recognized and used.

The microphone 20 of the hand-hygiene monitor 12, when provided, candetect sound within a particular frequency range, and in some cases adirection of the sound. In some cases, a plurality of microphones 20 maybe distributed around a hand washing sink, but this is not required. Themicrophone(s) 20 can detect water contacting the sink basin from thefaucet and/or the water contacting the sink basin from the person'shands. Each of these events can create a unique sound signature.Moreover, a scrubbing motion of the hands under the flow of water cancreate a unique sound signature relative to a person simply holdingtheir hands stationary under the flow of water. In some instances, themicrophone 20 can detect the sound of a soap dispenser being activatedor pumped. Identification of each of these events may be enhanced whenmore than one microphone is distributed about the hand washing station.Using more than one microphone may also help determine the direction ofthe sound, which may be used to help identify and/or distinguish betweenevents. A person could be deemed noncompliant with washing their handsif the person did not use soap. In some cases, the microphone 20 candetect the sound of a hand dryer blowing, a person drying their hands,and/or a paper towel dispensing, etc. In some cases, each of thefollowing actions or steps may be detected using the microphone 20:

1) water flowing from a faucet into a sink basin with no interference;

2) soap dispensing;

3) water flowing from a faucet into a sink basin with stationary handspositioned within the water flow;

4) water flowing from a faucet into a sink basin with moving hands(e.g., scrubbing) positioned within the water flow;

5) a hand dryer blowing;

6) a person drying their hands in a hand dryer; and

7) a paper towel dispensing.

The preceding list of actions and/or steps of a handwashing procedure(compliant or otherwise) is not intended to be inclusive of all actionsand/or steps that can be used to determine if a handwashing procedure iscompliant or not, but rather indicative of some of the types of actionsthat can be recognized and used.

The motion detector 52 and/or the radar 54, when present, may be used todetect the presence of a person in an area. The motion detector 52 cansense any movement within a particular area. The particular area can bea bathroom or an area in proximity to a faucet and/or sink. The motiondetector 52 data can indicate that an object was moving for a period oftime, which can suggest that a person was in the bathroom or in front ofa faucet for a particular amount of time. This time can be compared to athreshold quantity of time to determine if a person may have beenwashing hands and/or whether the amount of time was sufficient. Forexample, movement in front of the faucet for twenty seconds couldindicate that a person washed their hands for a sufficient period oftime.

The radar 54, unlike the motion detector 52, can detect a particularlocation of one or more people. The radar 54 can also detect thelocation of a person without the use of tags worn on the person.However, it is contemplated that radiofrequency tags can be used todetermine an identity of a person and/or to place the person at aspecific location (near an RF reader, for example). In some cases, theradar 54 can detect whether a person is standing within a particularproximity to a faucet. The radar 54 may also detect whether anotherperson is standing within a particular proximity to another faucet. Assuch, radar 54 can be used in areas with one or more sinks and cancollect location data on multiple people at a time. Various types ofradar 54 can be included in the hand-hygiene monitor 12. In someembodiments, the radar 54 can be a pulse-doppler radar. In otherembodiments, the radar 54 can be a frequency-modulated continuous waveradar. It is contemplated that the radar 54 may be used to detect aperson entering hand washing area and/or a person exiting the handwashing area. It is also contemplated that the radar 54, when directedat the sink, may be used to detect water flow without hand in the waterflow, water flow with hands in the water flow, a hand washing motion ofthe hands, a scrubbing motion of the hands/arms, etc. Some illustrativeprocedural compliance systems utilizing radar tracking are described incommonly assigned U.S. patent application Ser. No. 16/522,326 titled“Methods and Systems for Improving Infection Control in a Facility,” thedisclosure of which is hereby incorporated by reference.

It is contemplated that the processor 24 and/or procedural compliancemodule 30 of the hand-hygiene monitor 12 may combine or fuse the sensoroutput signals from the accelerometer 18, the microphone 20, the radar54 and/or other sensor. In one example, both the microphone 20 and/orthe accelerometer 18 are used to detect the faucet running and a handwashing motion under the running water, but if neither sensor detectedsoap dispensing, the data collected from the sensors of the hand-hygienemonitor 12 could suggest that the person did not use soap. This couldresult in the procedural compliance module 30 determining that theperson is noncompliant with the hand washing procedures. It is furthercontemplated that the location of the person (e.g., if the person hasentered and/or exited the hand washing area) may be verified ordetermined by the radar 54. Also, the radar 54 may be used to detecthand washing motion under a water flow, which may be used to confirm ahand washing motion detected by the accelerometer 18 and/or microphone20. This is just one example.

In some instances, a time duration that one or more of these activitiesoccur (e.g., a time duration of each action or step) can be tracked andcompared to a threshold quantity of time appropriate for a specificactivity to help determine whether the hand washing was in compliancewith hand washing procedures. For example, a vibration signatureindicative of interrupting the flow of water for twenty seconds couldindicate that a person washed their hands for a sufficient period oftime (e.g. greater than twenty seconds).

As described herein, sensors 16 in addition to (or in place of) theaccelerometer 18 and/or microphone 20 may also be provided in thehand-hygiene monitor 12. For example, as described above, thehand-hygiene monitor 12 may include a light sensor 44, a humidity sensor46, a temperature sensor 48, a magnetometer 50, a motion detector 52, aradar 54, and/or a combination thereof.

A light sensor 44 can detect whether a light is on. If the light is onin, for example, a bathroom this may be indicative of a person beingpresent in the bathroom. For example, many people turn lights off in abathroom to conserve energy when the bathroom is not in use. In someexamples, the lights in a bathroom are coupled to a motion detector andthe lights turn off after no motion has been detected after a particularperiod of time. As such, data collected from a light sensor 44 canindicate a person is not present, in response to the light sensor 44detecting less than a threshold amount of light and/or no light.

A humidity, temperature and/or magnetic forces in an area can change inresponse to a faucet running. In some examples, the humidity,temperature, and/or magnetic forces in an area can change in response toa person being present. As such, it is contemplated that data from thehumidity sensor 46, temperature sensor 48, and/or magnetometer 50 can beused to determine whether a faucet is running and/or whether a person ispresent, for example. Other sensors can provide additional data and/orsignatures to help increase the accuracy of the hand washing compliancedetermination. The sound and/or vibration signatures independently,together, or in combination with additional sensors can be used todetermine whether or not a person washed their hands. The sound and/orvibration signatures independently, together, or in combination withother sensors can also be used to determine how long the person washedtheir hands.

In some examples, analyzing a combination of the sound signatures,vibration signatures, and/or a combination of sound signatures,vibration signatures and other sensor data can increase the overallaccuracy of the processor 24 and/or procedural compliance module 30 indetermining whether a person is compliant with washing their hands.

The hand-hygiene monitor 12 may further include a transmit element 22.The transmit element 22 may be a transmitter or transceiver. Forexample, the transmit element 22 can be a radio frequency (RF)transceiver. In some examples, the transmit element 22 can be wired orwirelessly coupled to a processor and/or controller 24. The transmitelement 22 can transmit data detected and collected by sensors 16 of thehand-hygiene monitor 12 and/or a determination ofcompliance/non-compliance with established hand washing procedures. Thetransmit element 22 can transmit the data to an external computingdevice 14 and/or to another device 56, 58, 62.

In some examples, the processor 24 and/or procedural compliance module30 of the hand-hygiene monitor 12 can use a machine learning model todetermine whether a person washed their hands. For example, machinelearning methods may be used (for example, a support vector machine,deep neural networks, multi-way support vector machine, etc.) to detecthand washing events through the microphone 20, accelerometers 18, and/orother sensors 16 data. In parallel, a point cloud from a radar 54 may beused to deduce the position and identity of the personnel. The output ofthese two systems may be fused to come to a conclusion (e.g., the persondid or did not wash their hands). In some cases, the sensor 16 dataincluding the radar 54 may be input to a combined machine learning modelthat determines the presence, identity and hand washing compliance alltogether. In yet another example, different machine learning models arecreated as an ensemble and run in parallel—the results are then fusedand used to establish whether the hand washing was in compliance.

The hand-hygiene monitor 12 may include a compliance indicator 60.Although the compliance indicator 60 is shown included in thehand-hygiene monitor 12, the compliance indicator 60 can be outside ofthe hand-hygiene monitor 12. For example, the compliance indicator 60can be a separate device, built into a wearable device 56, built in to auser device 58, and/or a part of the computing device 14. The complianceindicator 60 can provide a visual, audible and/or haptic signal to aperson to indicate whether the person has complied with, or is incompliance with, a hand washing procedure. Hand washing compliance canbe tracked for a single hand washing activity or, in some embodiments,can be tracked over a period of time, such as a period of hours, days,weeks, months, years, etc. The signal of the compliance indicator 60 canbe, but is not limited to, a light, a symbol, a tone, a hapticvibration, and/or a combination thereof.

In some embodiments, the compliance indicator 60 can display a greenlight in response to the processor 24 and/or procedural compliancemodule 30 determined that a person washed their hands in compliance withhand washing standards. In some examples, the compliance indicator 60can display a red light in response to the processor 24 and/orprocedural compliance module 30 determined that a person did not washtheir hands in compliance with the hand washing standards. In someembodiments, the system 10 can include multiple compliance indicatorsthat each indicate compliance with a particular sub-activity involvingin compliant hand-washing, such as a first indicator for washing and adifferent indicator for using soap. Alternatively, the indicator couldhave multiple states at which it changes to a different state each timea sub-activity is accomplished (e.g., a first state for hand washing, asecond state for using soap, a third state for using a towel, etc.).

In some embodiments, the compliance indicator 60 can change visualsignals in response to a person washing their hands, washing their handsfor a particular amount of time, or once soap is dispensed. For example,the compliance indicator 60 can display a red light until the processor24 and/or procedural compliance module 30 indicates that the person haswashed their hands for thirty seconds, at which time the complianceindicator 60 can display a green light to let the person know that theycan stop washing their hands.

As described herein, the computing device 14 may be operatively coupledto the hand-hygiene monitor 12. The computing device 14 may be a systemspecific controller, a desktop computer, a laptop computer, a tablet, acloud based computing device, a cloud server, etc. When the hand-hygienemonitor 12 is equipped with a processing device 24 and memory 28, thecomputing device 14 may not be required for the function of the system10. When the computing device 14 is provided, the computing device 14may be located in a same room as the hand-hygiene monitor 12, in adifferent room but a same building as the hand-hygiene monitor 12, oroff-site (e.g., geographically different location) from the hand-hygienemonitor 12, as desired. The computing device 14 may include acommunications port 32 for communicating with the hand-hygiene monitor12 (or other devices, such as but not limited to, cell phones, wearabledevices, etc.), the wearable device 56, the user device 58, and/ortracking device 62. In some cases, the computing device 14 may includemore than one communications port 32 for communicating over more thanone network (e.g., wireless LAN, wired LAN, the Internet, short rangewireless communications, etc.). In some instances, the communicationsport 32 may be a radiofrequency (RF) transceiver.

The computing device 14 may further include a processor 34 (e.g.microprocessor, microcontroller, etc.) and a memory 36. The computingdevice 14 may also include a user interface 40. The user interface 40may be a display or other means for allowing a user to interact with thecomputing device 14. The user interface 40 may be part of a personalcomputer, tablet computer, smart phone, laptop computer, or may includea standalone display. In some instances, the computing device 14 mayinclude a user input 42 for receiving a user input from a user. Forexample, the user input may include a keyboard, mouse, actuatablebuttons, or a touchscreen display. These are just examples.

The memory 36 may be used to store any desired information, such as theaforementioned procedural compliance module. The memory 36 may be anysuitable type of storage device including, but not limited to, RAM, ROM,EPROM, flash memory, a hard drive, and/or the like. In some cases, theprocessor 34 may store information within the memory 36, and maysubsequently retrieve the stored information from the memory 36. In somecases, the memory 36 may store one or more application program modules(e.g., software), such as a procedural compliance module 38. Theprocedural compliance module 38 may be the same as or different from theprocedural compliance module 30 associated with the hand-hygiene monitor12. The procedural compliance module 38 may include one or more definedprocedures that should be performed in a particular room of a facilityin order to reduce the risk of infection. Each defined procedure mayinclude one more conditions or actions that should be met in order forthe procedure to have been considered as performed correctly or to astandard, as will be described in more detail herein. It is contemplatedthat the defined procedure may be different for different types of roomsand/or a category type of the person entering the room. In some cases,only one of the hand-hygiene monitor 12 or the computing device 14 isprovided with a procedural compliance module 30, 38. In other cases,both the hand-hygiene monitor 12 and the computing device 14 areprovided with a procedural compliance module 30, 38.

In some embodiments, a weighting value can be applied to one or moresensor data values if it is determined that a particular type of data ismore predictive of a person having good hand-hygiene. For example,accelerometer data may be more reliable than microphone data andtherefore a higher weighting value could be applied to one or moreaccelerometer data values relative to microphone data values. This isjust one example. Other weighting schemes may be used, as desired.Alternatively, or in addition, a machine learning model can be used bythe processor 24 and/or procedural compliance module 30 of thehand-hygiene monitor 12 and/or the processor 34 and/or proceduralcompliance module 38 of the computing device 14 to determine whether aperson was complaint in washing their hands. Data from the accelerometer18, data from the microphone 20, and/or data from other sensors 16 canbe input into the machine learning model to determine whether a personproperly washed their hands. The machine learning model can be, but isnot limited to, a support vector machine, a deep neural network, amulti-way support vector machine, or any other suitable machine learningand/or artificial intelligence model or algorithm.

The processor 24 and/or procedural compliance module 30 of thehand-hygiene monitor 12 and/or the processor 34 and/or proceduralcompliance module 38 of the computing device 14 can use a machinelearning model including statistical techniques to improve the accuracyof the system 10 over time. In some examples, machine learning and/orartificial intelligence can be used to perceive an environment, such asa bathroom, and adjust sensors and/or adjust a weighting value that theprocessor 24 and/or procedural compliance module 30 of the hand-hygienemonitor 12 and/or the processor 34 and/or procedural compliance module38 of the computing device 14 gives data from particular sensors toimprove probability of accurately determining whether a person compliedwith hand washing procedures.

The processor 24 and/or procedural compliance module 30 of thehand-hygiene monitor 12 and/or the processor 34 and/or proceduralcompliance module 38 of the computing device 14 can include an iterativelearning component. The machine learning model can be updatedperiodically to incorporate idiosyncrasies of the environment that thehand-hygiene monitor 12 is in. In some examples, the machine learningmodel can be updated to suppress particular sounds, for example, thesound of doors opening and/or closing. Moreover, the particular handwashing procedures may differ depending on the location within thefacility. For example, more rigorous hand washing/scrubbing may berequired at a and washing station servicing an operating room relativeto a hand washing station servicing a patient room. The machine learningmodel can learn to identify the particular hand washing proceduresassociated with a particular location.

The processor 24 and/or procedural compliance module 30 of thehand-hygiene monitor 12 and/or the processor 34 and/or proceduralcompliance module 38 of the computing device 14 can save the processorexecutable instructions that provide the machine learning component inthe respective memory 28, 36. The processor 24 and/or proceduralcompliance module 30 of the hand-hygiene monitor 12 and/or the processor34 and/or procedural compliance module 38 of the computing device 14 canalso save compliance data in the respective memory 28, 36. In somecases, the memory 28, 36 can include statistical data on people washingtheir hands, people washing their hands for a particular time, peoplewashing their hands with soap, and/or a combination thereof.

The wearable device 56, when provided, may be device that is worn by orcarried by a person (e.g., staff member). In some cases, the wearabledevice 56 may allow the system 10 to identify the staff member or astaff member classification (e.g., physician, nurse, food service, etc.)when they enter a room. The identity of the staff member may then beused to determine which procedure the staff member is expected to complywith when entering a particular room, if any. In some instances, thewearable device 56 may be used to help identify the location of theperson in the room. For example, the location of the person may beidentified when the person is in proximity to another device in the roomcapable of receiving a signal transmitted by the wearable device 56(e.g. beacon, RF tag reader, etc.).

In one example, the wearable device 56 may be a network or internetenabled bracelet or watch. It is contemplated that in addition toproviding information regarding the staff member, a bracelet may beequipped with gesture tracking technology and/or other sensors such asbut not limited to an accelerometer, a gyroscope, a magnetometer, ahumidity sensor, a temperature sensor, a moisture sensor, a microphone,etc. When so provided and worn on a wrist, a wearable device 56 may beused to provide information which may be used to determine if certainprocedures are being followed (e.g., hand sanitizing, hand washing,etc.), as will be described in more detail herein. In other examples,the wearable device 56 may be an employee badge with a radiofrequency(RF) tag. It is contemplated that other wearable devices 56 may also beused, including, but not limited to, rings, necklaces, cell phones, etc.In some cases, the wearable device 56 may be include a wirelesstransceiver to wirelessly communicate with the hand-hygiene monitor 12,the computing device 14, the user device 58 and/or any other suitabledevice. When so provided, it is contemplated that the wirelesstransceivers may communicate using a standard and/or a proprietarycommunication protocol. Suitable standard wireless protocols mayinclude, for example, cellular communication, ZigBee, Bluetooth, WiFi,IrDA, dedicated short range communication (DSRC), EnOcean, or any othersuitable wireless protocols, as desired. In some embodiments, the system10 may not include a wearable device 56.

The user device 58, when provided, may be a device carried by a staffmember as they are performing their duties. The user device 58 mayinclude, but is not limited to, mobile devices including smart phones,tablet computers, laptop computers, wireless network-enabled key fobs,e-readers, and/or the like. The user device 58 may be configured toreceive messages from the hand-hygiene monitor 12 and/or the computingdevice 14 regarding a procedure that is expected to be performed in aparticular room. In some cases, the messages may be informing the staffmember of the procedural requirements. In other cases, the messages maybe informing the staff member that they have failed to perform aprocedure or performed it incorrectly, as will be described in moredetail herein. In some embodiments, the system 10 may not include a userdevice 58.

In some instances, the system 10 may include a tracking device 62. It iscontemplated that the tracking device 62 may be a part of the wearabledevice 56 and/or the user device 58. For example, the tracking device 62can be included in an identification card, for example. In otherembodiments, the tracking device 62 may be a separate entity. In somecases, the tracking device 62 can be a vector or real-time locationsystem (RTLS).

In some examples, the tracking device 62 can be used in combination withthe data from the hand-hygiene monitor 12 to identify a person andwhether or not the person was in compliance with washing their hands.For example, the processor 24 and/or procedural compliance module 30 canmatch the hand-hygiene monitor 12 data at a particular time with aparticular person in response to the tracking device 62 placing theperson in front of the sink where the hand-hygiene monitor 12 is locatedat the particular time. The memory 28 can also include such trackingdevice 62 data.

FIG. 2 is a flow chart of an illustrative method 100 for using thesystem 10 of FIG. 1 to monitor procedural (e.g., hand washing)compliance of staff in a facility. To begin, one or more definedprocedures that are to be performed by a person in one or more rooms ofthe facility may be defined and stored in the memory 28, 36 of thehand-hygiene monitor 12 and/or computing device 14, as shown at block102. It is contemplated that when the one or more defined procedures arestored in the memory 28 of the hand-hygiene monitor 12, the one or moredefined procedures may be specific to the particular room in which thehand-hygiene monitor 12 is located. In other cases, all of the definedprocedures, regardless of the room type to which they apply, may bestored in the same database (e.g., in the same memory). Each definedprocedure may include predetermined criteria that must be met for thedefined procedure or hand washing procedure to be considered correctlycompleted. In some cases, the predetermined criteria may include two ormore distinct hand washing steps and/or a length of time a hand washingstep should be performed.

For example, when washing hands, a person may be expected to wash theirhands at a sink. Thus, in some cases, the criteria may include locatingthe person near the sink. The hand washing steps may include, but arenot limited to:

1) approaching the hand washing station or sink;

2) turning on the water;

3) dispensing of soap (at the hand washing station or sink);

4) scrubbing of hands;

5) turning off the water;

6) drying of hands (e.g., through the use of a hand dryer, paper towels,etc.)

7) departing the hand washing station or sink.

It is contemplated that not all of the above steps are required to beperformed for the user to be considered in compliance with thepredetermined criteria. Further, additional steps may be requireddepending on the location of the hand-hygiene monitor 12. For example,an operating room may have more rigorous standards than a patient room.Some or all of the hand washing steps may include an associated lengthof time or minimum threshold time that the action should be performed.For example, a person may be required to scrub their hands for a minimumof 20 seconds or more to be considered as complying with therequirements of the scrubbing action or step. The predetermined criteriamay be defined or programmed during commissioning of the hand-hygienemonitor 12 and/or computing device 14. In some cases, the predefinedcriteria may be updated or changed after commissioning. It is furthercontemplated that the some or all of the aspects of the predefinedcriteria may be learned using multi-factor machine learning or othermachine learning technique. For example, the hand washing procedure maybe performed one or more times while the system 10 is in a commissioningmode to allow the system 10 to recognize the vibrations, sounds,locations, and/or other signals that indicate a user is washing theirhands in accordance with a set procedure. It is further contemplatedthat during commissioning and/or standard operation, the location of theperson and/or the hand scrubbing motions may be verified using the radar54. The predefined criteria may be updated periodically to incorporateany idiosyncrasies of the environment the hand-hygiene monitor 12 isoperating in.

Once the defined procedures and/or predefined criteria have been stored,the system 10 may be used to monitor for procedural compliance. Thesystem 10 (e.g., the processor 24 and or procedural compliance module 30of the hand-hygiene monitor 12 and/or the processor 34 and/or proceduralcompliance module 38 of the computing device 14) may be configured toreceive sensor output signals from at least two more sensors 16, asshown at block 104. The two or more sensors 16 may include anaccelerometer 18 and a microphone 20, an accelerometer 18 and a radar,an microphone and a radar 54, etc. In some cases, one or more additionalsensors, such as, but not limited to, a light sensor 44, a humiditysensor 46, a temperature sensor 48, a magnetometer 50, a motion detector52, a radar 54, or a combination thereof, may be used in combinationwith, for example, the accelerometer 18 and/or the microphone 20. Asdescribed above, the sensor output signals may be unique and indicativeof various actions being performed in the proximity of the sensors 16.

The system 10 (e.g., the processor 24 and or procedural compliancemodule 30 of the hand-hygiene monitor 12 and/or the processor 34 and/orprocedural compliance module 38 of the computing device 14) may fuse orcombine the sensor output signals from the at least two or more sensors16, as shown at block 106. It is contemplated that fusing the sensoroutput signals may increase the confidence that a particular step oraction is correctly identified. For example, the signals may be analyzedtogether to determine location, hand washing, and/or identity.

The system 10 may be configured to determine whether or not the one ormore predefined criteria or conditions of the defined procedure havebeen met, as shown at block 108. The system 10 may be configured tocompare a location of the person, an action or hand washing stepperformed by the person, a length of time the person has performed theaction or step, to the one or more conditions of the defined procedures.This may include tracking the order of occurrence of the detected handwashing step.

Regardless of whether or not the person has met the one or moreconditions of the defined procedure (e.g., location, action or step,and/or time), the system 10 may issue a notification or provide analert, as shown at block 110. It is contemplated that the notificationmay be provided in real time so that the person has a chance to correcttheir mistake if the hand washing criteria were not met. In some cases,the alert may be provided directly to the user device 58 and/or thewearable device 56 of the person in the room. An illustrative alert mayremind the user to perform the defined procedure (e.g., hand-hygiene).In other cases, an alert may be provided to a central location, such as,but not limited to, a nurses' station, supervisor, management, etc. Insome cases, the room itself may have an alerting device, such as, butnot limited to the compliance indicator 60 described herein, that canannunciate the alert to the person in the room.

In an illustrative example, an alert may be provided when a nurse orphysician enters a patient room but fails to pause or stop at the handsanitizing station or at the sink, fails to turn on the water, fails todispense soap, etc. The alert may remind the user of the hand-hygieneprocedure. It is contemplated that the alert may be a plain text alert(e.g., please wash your hands or please return to the hand sanitizer,etc.), a visual alert (e.g., an illuminated light), an audible alert(e.g., a beep or series of beeps), a haptic alert (e.g., a vibration ofthe wearable device 56 or the user device 58), etc.

FIG. 3 is a schematic block diagram of another illustrative system 200for monitoring procedural (e.g., hand washing or hand-hygiene)compliance of staff in a hospital or other clinical setting. The system200 may determine if a person has washed their hands at a hand washingstation in compliance with one or more predetermined criteria. Thedetermination may be made without the use of cameras which output avisually perceptible image of the hand washing station. For example, thesystem 200 may be configured to use an array of thermal imaging sensorsthat are minimally obtrusive to detect and alert hand-hygiene incidents.Generally, the system 200 may include a hand-hygiene monitor 202 and insome cases a computing device 204. In some cases, the informationprocessing may be performed at the hand-hygiene monitor 202 and aseparate computing device 204 may not be required. The system 200 mayoptionally include a wearable device 206 (e.g., a watch, a bracelet, afitness tracker, an identification badge, etc.), a user device 208(e.g., a cell phone, a tablet computer, etc.) carried by the personentering the room, and/or a tracking device 210. In some cases, thehand-hygiene monitor 202 may a separate system that is placed in aparticular area (e.g., near a hand washing station).

The hand-hygiene monitor 202 may include a communications port 212 foroperatively coupling to the computing device 204, the wearable device206, the user device 208, and/or the tracking device 210. It iscontemplated that the communications port 212 may be wired and/orwireless. When the communications port 212 is wireless, thecommunications port 212 may include a wireless transceiver, and thecomputing device 204, the wearable device 206, the user device 208,and/or the tracking device 210 may include a compatible wirelesstransceiver. It is contemplated that the wireless transceivers maycommunicate using a standard and/or a proprietary communicationprotocol. Suitable standard wireless protocols may include, for example,cellular communication, ZigBee, Bluetooth, WiFi, IrDA, dedicated shortrange communication (DSRC), EnOcean, or any other suitable wirelessprotocols, as desired.

The hand-hygiene monitor 202 may include one or more controllers orprocessors 214 that execute instructions stored in the system memory216. In some cases, the controller 214 may include a programmablemicroprocessor. Such a programmable microprocessor may allow a user tomodify the control logic of the hand-hygiene monitor 202 even after itis installed in the field (e.g., firmware update, application update).The system memory 216 of the hand-hygiene monitor 202 can includecomputer system readable media in the form of volatile memory, such asrandom access memory (RAM) and/or cache memory. The hand-hygiene monitor202 may further include other removable/non-removable,volatile/non-volatile computer system storage media. By way of exampleonly, the storage system can be provided for reading from and writing toa non-removable, non-volatile magnetic media (not shown and typicallycalled a “hard drive” or flash memory). The system controller 214 and/ormemory 216 may include at least one program/utility having a set ofprogram modules that are configured to receive an input from or transmitan output to a remote computing device 204, a wearable device 206, auser device 208, and/or a tracking device 210.

In one example, the program/utility may be stored in the system memory216 and may include one or more application program modules (e.g.,software), such as a procedural compliance module 218. The proceduralcompliance module 218 may include one or more defined hand washingprocedures that should be performed in a particular room of a facilityin order to reduce the risk of infection. Each defined procedure mayinclude one more predefined criteria, conditions, or actions that shouldbe performed in order for the procedure to have been considered asperformed correctly or to a standard, as will be described in moredetail herein. It is contemplated that the defined procedure may bedifferent for different types of rooms and/or a category type of theperson entering the room. For example, the defined procedures for anoperating room (OR) may be different than the defined procedures for apatient room. In some cases, the procedural compliance module 218 may bea part of the hand-hygiene monitor 202 or may be executed on the remotecomputing device 204, as will be described in more detail herein.

The hand-hygiene monitor 202 may include an array of thermal imagingsensors 220. In some instances, the array of thermal imaging sensors 220may be used in combination with any or all of the sensors 16 of thesystem 10 described above. The array of thermal imaging sensors 220 mayinclude a two-dimensional array of pixels which allow for a temperaturedetection of a two-dimensional area. It is contemplated that the arrayof thermal imaging sensors 220 may include four or more individuallyreadable pixels arranged in two or more rows and two or more columns,and may be used to acquire a thermal image. In some cases, the array ofthermal imaging sensors 220 may include a two dimensional array ofpassive infrared pixels. Example two dimensional arrays of passiveinfrared pixels include a 2×2 array, a 2×3 array, a 2×4 array, a 3×3array, a 4×4 array, a 6×6 array, an 8×8 array, a 16×16 array, a 32×32array, a 64×64 array, a 128×128 array, and/or any other suitable twodimensional array as desired. The array of thermal imaging sensors 220may be an infrared array sensor based on advanced microelectromechanicalsystems (MEMS), such as, but not limited to the Infrared Array SensorGrid-EYE manufactured Panasonic with a North American base in Secaucus,N.J.

Thermal images may be stored, at least temporarily, in the memory 216 ofthe hand-hygiene monitor 202. The resolution of the thermal image may bedetermined by the number of individually readable pixels of array ofthermal imaging sensors 220. For example, an 8×8 array of individuallyreadable pixels will result in 64 different temperature data points perframe acquired. The array of thermal imaging sensors 220 may have arelatively low resolution to allow it to be used in facilities wheretypical cameras are not allowed for privacy reasons. For example, thearray of thermal imaging sensors 220 may not output a visuallyperceptible image of the hand washing station.

Referring additionally to FIG. 4, which is a perspective view of anillustrative hand washing station 250, the array of thermal imagingsensors 220 may be mounted, for example, to a wall, behind a faucet 256and/or one or more faucet handles or levers 258 a, 258 b (collectively258). In some cases, more than one array of thermal imaging sensors 220may be provided. For example, the hand washing station 250 of FIG. 4includes a first array of thermal imaging sensors 220 a, a second arrayof thermal imaging sensors 220 b, and a third array of thermal imagingsensors 220 c (collectively, 220). While the hand washing station 250 isillustrated as include three array of thermal imaging sensors 220, thehand washing station 250 may include any number of array of thermalimaging sensors 220 desired, such as, but not limited to, one, two,three, four, or more. The array of thermal imaging sensors 220 may bepositioned such that the field of view is focused on the water flowand/or the expected positioning of a person's hands while they arewashing their hands. It is contemplated that when more than one array ofthermal imaging sensors 220 is provided, the array of thermal imagingsensors 220 may be horizontally and/or vertically spaced to providefield of views from different angles of the region of interest. In theevent that one of the array of thermal imaging sensors 220 is blocked orotherwise has the field of view obstructed, another of the array ofthermal imaging sensors 220 may be positioned to capture a thermal imageof the sink basin area 254. In some cases, the array of thermal imagingsensors 220 may be mounted to bar 260 or other mechanism to facilitateinstallation. In some embodiments, the array of thermal imaging sensors220 may be battery powered. In other embodiments, the array of thermalimaging sensors 220 may be wired into a preexisting electrical systemand/or plugged into an electrical outlet.

The hand washing station 250 may further include a soap dispenser 252.In some cases, the soap dispenser 252 may include an RFID reader whichis configured to identify a user and/or verify the user was withinproximity of the soap dispenser 252. The RFID reader may be configuredto read an RFID tag associated with the user's identification badge orother user device 208 to determine the identity of the user. It isfurther contemplated that additional sensing methods may be used todetermine the soap has been dispensed. For example, microphones may beused to listen for the sound of the soap being dispensed. This is justone example. Other sensing modalities may be used, as desired.

While not explicitly shown the array of thermal imaging sensors 220 mayalso be positioned adjacent to a waterless hand sanitizing station. Insuch a configuration, the array of thermal imaging sensors 220 mayfunction in a similar manner to that described with respect to the handwashing station 250.

Returning to FIG. 3, the array of thermal imaging sensors 220 may beconfigured to detect water flow and/or and scrubbing movements. Forexample, the temperature of the water flowing from the faucet 256 may bedifferent from the temperature of the background. Thus, the flow ofwater relative to the background can be identified. Further, a person'shands may also have a different temperature from the water and/or thebackground. The array of thermal imaging sensors 220 may be furtherconfigured to capture images at a predetermined frame rate which mayallow the system 200 to determine if the hands are moving within thewater flow. This may allow the controller 214 and/or proceduralcompliance module 218 to determine if water is running, whether or nothands are present and/or whether the hands are being moved in ascrubbing motion. It is further contemplated that the controller 214and/or procedural compliance module 218 may be configured to measure alength of time each action occurs. For example, the controller 214and/or procedural compliance module 218 may determine how long thefaucet was running and/or how long the person was washing their handsbased on the acquired thermal images. In some examples, a person couldbe deemed noncompliant with washing their hands if the person did notwash their hands for a particular period of time.

The controller 214 and/or procedural compliance module 218 may beconfigured to combine or fuse the sensor output signals from two or moresensors, if so provided. For example, sensors, such as, RFIDreaders/tags, radars, microphones, etc. may be used to increase theconfidence the system has made the appropriate determination. Thecontroller 214 and/or procedural compliance module 218 may then use thefused sensor signal outputs to determine whether the person has washedtheir hands at the hand washing station in compliance with one or morepredetermined criteria or not. Alternatively, the controller 214 and/orprocedural compliance module 218 may determine whether the person haswashed their hands at the hand washing station in compliance with one ormore predetermined criteria or not based on the thermal images. It isfurther contemplated that the controller 214 and/or proceduralcompliance module 218 may be configured to output a notification whenthe controller 214 and/or procedural compliance module 218 hasdetermined that the person has washed their hands at the hand washingstation in compliance with the one or more predetermined criteria.

The controller 214 and/or procedural compliance module 218 may beconfigured to analyze the thermal images and/or sensor data to determineif a sequence of events has occurred in a particular order. In oneillustrative example, a sequence of events may include:

1) Soap dispensed;

2) Water flowing;

3) Hand scrubbing; and

4) Dwell time.

The preceding list of actions and/or steps of a handwashing procedure(compliant or otherwise) and/or the order thereof is not intended to beinclusive of all actions and/or steps that can be used to determine if ahandwashing procedure is compliant or not, but rather indicative of someof the types of actions that can be recognized and used. For example,the sequence of events and/or dwell time can vary based on the type ofhand-hygiene procedure.

The detection of one or more of these events can also be to determinewhether a person is compliant with washing their hands. For example, ifthe array of thermal imaging sensors 220 detected water running but didnot detect hand scrubbing, the data collected by the array of thermalimaging sensors 220 can suggest and the procedural compliance module 218(or processor 214) can determine that a person did not wash their hands.

It is contemplated that combining the data from the array of thermalimaging sensors 220 with data from other sensors can increase theaccuracy of the procedural compliance module 218 by providing theprocessor 214 and/or procedural compliance module 218 with more data tomake a more informed decision on whether a person washed their hands.For example, in some embodiments, a moisture sensor and/or humiditysensor may be positioned in the wearable device 206 (e.g., a wrist worndevice). The moisture sensor and/or humidity sensor may be configured todetect a change in moisture or humidity adjacent to the wearable device206 that can be associated with wet hand (e.g., from washing hands). Itis further contemplated that the location of the person (e.g., if theperson has entered and/or exited the hand washing area) may be verifiedor determined by a radar.

In some embodiments a time period for one of these activities occur(e.g., a time duration of each action or step) can be compared to athreshold quantity of time appropriate for a specific activity todetermine if a person may have been engaging in the activity and/orwhether the amount of time was sufficient. For example, a thermal imageswhich indicate scrubbing hands for twenty seconds could indicate that aperson washed their hands for a sufficient period of time. Additionally,or alternatively, the length of time a person remains at the handwashing station 250, or dwell time, may be used.

described herein, sensors in addition to (or in place of) the array ofthermal imaging sensors 220 may also be provided in the hand-hygienemonitor 202. For example, the hand-hygiene monitor 202 may include alight sensor, a humidity sensor, a temperature sensor, a magnetometer, amotion detector, a radar, or a combination thereof. Other sensors canprovide additional data and/or increase the accuracy of the hand washingcompliance data. The thermal images alone or in combination withadditional sensors can be used to determine whether or not a personwashed their hands and/or how long the person washed their hands.

The hand-hygiene monitor 202 may further include a transmit element 222.The transmit element 222 may be a transmitter or transceiver. Forexample, the transmit element 222 can be a radio frequency (RF)transceiver. In some examples, the transmit element 222 can be wired orwirelessly coupled to a processor and/or controller 214. The transmitelement 222 can transmit data (e.g., images) detected and collected thearray of thermal imaging sensors 220 of the hand-hygiene monitor 202.The transmit element 222 can transmit the data to the processor 214, toan external computing device 204, and/or to another device 206, 208,210. In a number of embodiments, the processor 214 can be included inthe hand-hygiene monitor 202. In some embodiments, the processor 214 canbe configured to receive the data from the transmit element 222, asdescribed above. The processor 214 and/or procedural compliance module218 can use the data received from the transmit element 222 to determinewhether a person washed their hands by analyzing the data detectedand/or collected by the array of thermal imaging sensors 220 and/orother suitable sensors. In some examples, the processor 214 and/orprocedural compliance module 218 can use a machine learning model todetermine whether a person washed their hands.

For example, in one embodiment machine learning methods may be used (forexample, a support vector machine) to detect the hand washing eventthrough the array of thermal imaging sensors 220 and/or other sensors.In parallel, the point cloud from a radar may be used to deduce theposition and identity of the personnel. The output of these two systemsmay then be fused to come to a conclusion (e.g., the person did or didnot wash their hands). In other embodiments, the array of thermalimaging sensors 220 and radar data or both are input to a combinedmachine learning model that determines the presence, identity and handwashing all together. In yet another embodiment all three models aboveare created as an ensemble and run in parallel—the results from thethree models are then fused and used to establish the predefinedcriteria. Finally, some embodiments may use different machine learningand artificial intelligence methods such as a support vector machine,deep neural networks, multi-way support vector machine etc. and createensembles of these different models.

The hand-hygiene monitor 202 may further include a compliance indicator224. Although the compliance indicator 224 is shown included in thehand-hygiene monitor 202, the compliance indicator 224 can be outside ofthe hand-hygiene monitor 202. For example, the compliance indicator 224can be a separate device, built into a wearable device 206, built in toa user device 208, or a part of the computing device 204. The complianceindicator 224 can provide a visual and/or audible signal to a person toindicate whether the person has complied with, or is in compliance with,a hand washing procedure. Hand washing compliance can be tracked for asingle hand washing activity or, in some embodiments, can be over aperiod of time, such as a period of hours, days, weeks, etc. The signalof the compliance indicator 224 can be, but is not limited to, a light,a symbol, a tone, or a combination thereof. The compliance indicator 224may be similar in form and function to the compliance indicator 60described above.

As described herein, the computing device 204 may be operatively coupledto the hand-hygiene monitor 202. The computing device 204 may be asystem specific controller, a desktop computer, a laptop computer, atablet, a cloud based computing device, a cloud server, etc. When thehand-hygiene monitor 202 is equipped with a processing device 214 andmemory 216, the computing device 204 may not be required for thefunction of the system 200. When the computing device 204 is provided,the computing device 204 may be located in a same room as thehand-hygiene monitor 202, in a different room but a same building as thehand-hygiene monitor 202, or off-site (e.g., geographically differentlocation) from the hand-hygiene monitor 202, as desired. The computingdevice 204 may include a communications port 226 (or receive element)for communicating with the hand-hygiene monitor 202 (or other devices,such as but not limited to, cell phones, wearable devices, etc.), thewearable device 206, the user device 208, and/or tracking device 210. Insome cases, the computing device 204 may include more than onecommunications port 226 for communicating over more than one network(e.g., wireless LAN, wired LAN, the Internet, short range wirelesscommunications, etc.). The communications port 226 may be a receiver ora transceiver. In some instances, the communications port 226 may be aradiofrequency (RF) transceiver.

The computing device 204 may further include a processor 228 (e.g.microprocessor, microcontroller, etc.) and a memory 230. The computingdevice 204 may also include a user interface 232. The user interface 232may be a display or other means for allowing a user to interact with thecomputing device 204. The user interface 232 may be part of a personalcomputer, tablet computer, smart phone, laptop computer, or may includea standalone display. In some instances, the computing device 204 mayinclude a user input 234 for receiving a user input from a user. Forexample, the user input may include a keyboard, mouse, actuatablebuttons, or a touchscreen display. These are just examples.

The memory 230 may be used to store any desired information, such as theaforementioned procedural compliance module. The memory 230 may be anysuitable type of storage device including, but not limited to, RAM, ROM,EPROM, flash memory, a hard drive, and/or the like. In some cases, theprocessor 228 may store information within the memory 230, and maysubsequently retrieve the stored information from the memory 230. Insome cases, the memory 230 may store one or more application programmodules (e.g., software), such as a procedural compliance module 236.The procedural compliance module 236 may be the same as or differentfrom the procedural compliance module 218 associated with thehand-hygiene monitor 202. The procedural compliance module 236 mayinclude one or more defined procedures that should be performed in aparticular room of a facility in order to reduce the risk of infection.Each defined procedure may include one more conditions or actions thatshould be met (sometimes in a specific order) in order for the procedureto have been considered as performed correctly or to a standard, as willbe described in more detail herein. It is contemplated that the definedprocedure may be different for different types of rooms and/or acategory type of the person entering the room. In some cases, only oneof the hand-hygiene monitor 202 or the computing device 204 is providedwith a procedural compliance module 218, 236. In other cases, both thehand-hygiene monitor 202 and the computing device 204 are provided witha procedural compliance module 218, 236.

In some embodiments, a weighting value can be applied to one or moresensor data values if it is determined that a particular type of data ismore predictive of a person having good hand-hygiene. For example,accelerometer data may be more reliable than microphone data andtherefore a positive weighting value could be applied to one or moreaccelerometer data values or a negative weighting value could be appliedto one or more microphone data values. This is just one example. Otherweighting schemes may be used, as desired.

As discussed above, a machine learning model can be used by theprocessor 214 and/or procedural compliance module 218 of thehand-hygiene monitor 202 and/or the processor 228 and/or module 236 ofthe computing device 204 to determine whether a person was complaint inwashing their hands. Data from the array of thermal imaging sensors 220and/or data from other sensors can be input into the machine learningmodel to determine whether a person washed their hands. The machinelearning model can be, but is not limited to, a support vector machine,a deep neural network, or a multi-way support vector machine, forexample.

The processor 214 and/or procedural compliance module 218 of thehand-hygiene monitor 202 and/or the processor 228 and/or module 236 ofthe computing device 204 can use a machine learning model includingstatistical techniques to improve the accuracy of the system 200 overtime. In some examples, machine learning and/or artificial intelligencecan be used to perceive an environment, such as a bathroom, and adjustsensors and/or adjust a weighting value the processor 214 and/orprocedural compliance module 218 of the hand-hygiene monitor 202 and/orthe processor 228 and/or module 236 of the computing device 204 givesdata from a particular sensor to improve probability of accuratelydetermining whether a person complied with washing their hands.

The processor 214 and/or procedural compliance module 218 of thehand-hygiene monitor 202 and/or the processor 228 and/or module 236 ofthe computing device 204 can include an iterative learning component.The machine learning model can be updated periodically to incorporateidiosyncrasies of the environment that the hand-hygiene monitor 202 isin. In some examples, the machine learning model can be updated tosuppress particular sounds, for example, the sound of doors openingand/or closing.

The processor 214 and/or procedural compliance module 218 of thehand-hygiene monitor 202 and/or the processor 228 and/or module 236 ofthe computing device 204 can save the processor executable instructionsthat provide the machine learning component in the respective memory216, 230. The processor 214 and/or procedural compliance module 218 ofthe hand-hygiene monitor 202 and/or the processor 228 and/or module 236of the computing device 204 can also save compliance data in therespective memory 216, 230. For example, the memory 216, 230 can includestatistical data on people washing their hands, people washing theirhands for a particular time, people washing their hands with soap,and/or a combination thereof.

The wearable device 206 may be device that is worn by or carried by aperson (e.g., staff member). In some cases, the wearable device 206 mayallow the system 200 to identify the staff member or a staff member type(e.g., physician, nurse, food service, etc.) when they enter a room. Theidentity of the staff member may then be used to determine whichprocedure the staff is expected to comply with when entering aparticular room, if any. In some embodiments, the wearable device 206may be used to identify the location of the person in the room. Forexample, the location of the person may be identified determining whenthe person is in proximity to another device in the room capable ofreceiving a signal transmitted by the wearable device 206.

In one example, the wearable device 206 may be a network or internetenabled bracelet or watch. It is contemplated that in addition toproviding information regarding the staff, a bracelet may be equippedwith gesture tracking technology and/or other sensors such as but notlimited to humidity or moisture sensors. When so provided and worn on awrist, a wearable device 206 may be used to provide additionalinformation which may be used to determine if certain procedures arebeing followed (e.g., hand sanitizing, hand washing, etc.), as will bedescribed in more detail herein. In other examples, the wearable device206 may be an employee badge with a radiofrequency (RF) tag. It iscontemplated that other wearable devices 206 may also be used,including, but not limited to, rings, necklaces, cell phones, etc. Insome cases, the wearable device 206 may be include a wirelesstransceiver to wirelessly communicate with the hand-hygiene monitor 202,the computing device 204 and/or the user device 208. When so provided,it is contemplated that the wireless transceivers may communicate usinga standard and/or a proprietary communication protocol. Suitablestandard wireless protocols may include, for example, cellularcommunication, ZigBee, Bluetooth, WiFi, IrDA, dedicated short rangecommunication (DSRC), EnOcean, or any other suitable wireless protocols,as desired. In some embodiments, the system 200 may not include awearable device 206.

The user device 208 may be a device carried by a staff member as theyare performing their duties. The user device 208 may include, but is notlimited to, mobile devices including smart phones, tablet computers,laptop computers, wireless network-enabled key fobs, e-readers, and/orthe like. The user device 208 may be configured to receive messages fromthe hand-hygiene monitor 202 and/or the computing device 204 regarding aprocedure that is expected to be performed in a particular room. In somecases, the messages may be informing the staff of the proceduralrequirements. In other cases, the messages may be informing the staffthey have failed to perform a procedure or performed it incorrectly, aswill be described in more detail herein. In some embodiments, the system200 may not include a user device 208.

The system 200 can include a tracking device 210. It is contemplatedthat the tracking device 210 may be a part of the wearable device 206and/or the user device 208. For example, the tracking device 210 can beincluded in an identification card, for example. In other embodiments,the tracking device 210 may be a separate entity. For example, thetracking device 210 can be a vector or real-time location system (RTLS).

In some examples, the tracking device 210 can be used in combinationwith the data from the hand-hygiene monitor 202 to identify a person andwhether or not they were in compliance with washing their hands. Forexample, the processor 214 and/or procedural compliance module 218 canmatch the hand-hygiene monitor 202 data at a particular time with aperson in response to the tracking device 210 placing the person infront of the sink where the hand-hygiene monitor 202 is located at theparticular time. The memory 216 can also include such tracking device210 data.

FIG. 5 is a flow chart of an illustrative method 300 for using thesystem 200 of FIG. 3 to monitor procedural (e.g., hand washing)compliance of staff in a facility. To begin, one or more definedprocedures that are to be performed by a person in one or more rooms ofthe facility may be defined and stored in the memory 216, 230 of thehand-hygiene monitor 202 and/or computing device 204, as shown at block302. It is contemplated that when the one or more defined procedures arestored in the memory 216 of the hand-hygiene monitor 202, the one ormore defined procedures may be specific to the particular room in whichthe hand-hygiene monitor 202 is located. In other cases, all of thedefined procedures, regardless of the room type to which they apply, maybe stored in the same database (e.g., in the same memory). Each definedprocedure may include predetermined criteria that must be met for thedefined procedure or hand washing procedure to be considered correctlycompleted. In some cases, the predetermined criteria may include two ormore distinct hand washing steps, an order in which the hand washingsteps are to be performed and/or a length of time a hand washing stepshould be performed.

For example, when washing hands, a person may be expected to wash theirhands at a sink. Thus, in some cases, the criteria may include locatingthe person near the sink. The hand washing steps may include, but arenot limited to:

1) approaching the hand washing station or sink;

2) turning on the water;

3) dispensing of soap (at the hand washing station or sink);

4) scrubbing of hands;

5) turning off the water;

6) drying of hands (e.g., through the use of a hand dryer, paper towels,etc.)

7) departing the hand washing station or sink.

It is contemplated that not all of the above steps are required to beperformed for the user to be considered in compliance with thepredetermined criteria. Further, additional steps may be requireddepending on the location of the hand-hygiene monitor 202. For example,an operating room may have more rigorous standards than a patient room.Some or all of the hand washing steps may include an associated lengthof time or minimum threshold time that the action should be performedfor. For example, a person may be required to scrub their hands for aminimum of 20 seconds or more to be considered as complying with therequirements of the scrubbing action or step. The predetermined criteriamay be defined or programmed during commissioning of the hand-hygienemonitor 202 and/or computing device 204. In some cases, the predefinedcriteria may be updated or changed after commissioning. It is furthercontemplated that the some or all of the aspects of the predefinedcriteria may be learned using multi-factor machine learning or othermachine learning technique. For example, the hand washing procedure maybe performed one or more times while the system 200 is in acommissioning mode to allow the system 200 to recognize a thermalprofile, locations, and/or other signals that indicate a user is washingtheir hands in accordance with a set procedure. It is furthercontemplated that during commissioning and/or standard operation, thelocation of the person and/or the hand scrubbing motions may be verifiedusing a radar. The predefined criteria may be updated periodically toincorporate any idiosyncrasies of the environment the hand-hygienemonitor 202 is operating in.

Once the defined procedures and/or predefined criteria have been stored,the system 200 may be used to monitor for procedural compliance. Thesystem 200 (e.g., the processor 214 and or procedural compliance module218 of the hand-hygiene monitor 202 and/or the processor 228 and/ormodule 236 of the computing device 204) may be configured to receivethermal images from array of thermal imaging sensors 220, as shown atblock 304. In some cases, the system 200 may receive data from one ormore additional sensors, such as, but not limited, a radar, and RFIDreader/tag, an accelerometer, a microphone, a light sensor 44, ahumidity sensor 46, a temperature sensor 48, a magnetometer 50, a motiondetector 52, or a combination thereof. As described above, the sensoroutput signals (e.g., thermal images) may be unique and indicative ofvarious actions being performed in the proximity of the array of thermalimaging sensors 220.

The system 200 (e.g., the processor 214 and or procedural compliancemodule 218 of the hand-hygiene monitor 202 and/or the processor 228and/or module 236 of the computing device 204) may fuse or combine thesensor output signals if two or more sensors output signals arereceived, as shown at block 306. It is contemplated that fusing thesensor output signals may increase the confidence that a step or actionis correctly identified. For example, the signals may be analyzedtogether to determine location, hand washing, and/or identity. However,output signals from more than one sensor is not required.

The system 200 may be configured to determine whether or not the one ormore predefined criteria or conditions of the defined procedure havebeen met, as shown at block 308. The system 200 may be configured tocompare a location of the person, an action or hand washing stepperformed by the person, a length of time the person has performed theaction or step, etc. to the one or more conditions of the definedprocedures. Regardless of whether or not the person has met the one ormore conditions of the defined procedure (e.g., location, action orstep, and/or time), the system 200 may issue a notification or providean alert, as shown at block 310. It is contemplated that thenotification may be provided in real time so that the person has achance to correct their mistake if the hand washing criteria were notmet. In some cases, the alert may be provided directly to the userdevice 208 and/or the wearable device 206 of the person in the room. Anillustrative alert may remind the user to perform the defined procedure(e.g., hand-hygiene). In other cases, an alert may be provided to acentral location, such as, but not limited to, a nurses' station,supervisor, management, etc. In some cases, the room itself may have analerting device, such as, but not limited to the compliance indicator224 described herein, that can annunciate the alert to the person in theroom.

In an illustrative example, an alert may be provided when a nurse orphysician enters a patient room but fails to pause or stop at the handsanitizing station or at the sink, fails to turn on the water, fails todispense soap, etc. The alert may remind the user of the hand-hygieneprocedure. It is contemplated that the alert may be a plain text alert(e.g., please wash your hands or please return to the hand sanitizer,etc.), a visual alert (e.g., an illuminated light), an audible alert(e.g., a beep or series of beeps), a haptic alert (e.g., a vibration ofthe wearable device 206 or the user device 208), etc.

EXAMPLES

In a first example, a hand-hygiene monitor may comprise an accelerometerto detect vibration within a first range, a microphone to detect soundwithin a second range, and a transmit element to transmit data detectedby the accelerometer and the microphone.

Alternatively or additionally to any of the examples above, in anotherexample, the hand-hygiene monitor may further comprise a light sensor todetect whether a light is on to determine whether a person is present.

Alternatively or additionally to any of the examples above, in anotherexample, the hand-hygiene monitor may further comprise a radar to detectwhether a person is standing within a particular proximity of a faucet.

Alternatively or additionally to any of the examples above, in anotherexample, the hand-hygiene monitor may further comprise a humidity sensorto detect a humidity change to determine whether a faucet is running.

Alternatively or additionally to any of the examples above, in anotherexample, the hand-hygiene monitor may further comprise a temperaturesensor to detect a temperature change to determine whether a faucet isrunning.

Alternatively or additionally to any of the examples above, in anotherexample, the hand-hygiene monitor may further comprise a motion detectorto detect whether a person has entered an area.

Alternatively or additionally to any of the examples above, in anotherexample, the hand-hygiene monitor may further comprise a magnetometer todetect a change in magnetic forces to determine whether a faucet isrunning.

Alternatively or additionally to any of the examples above, in anotherexample, the hand-hygiene monitor may further comprise a processor todetermine whether a person washed their hands by analyzing the datadetected by the accelerometer and the microphone using a machinelearning model.

Alternatively or additionally to any of the examples above, in anotherexample, the hand-hygiene monitor may further comprise the hand-hygienemonitor is worn by a person.

In another example, a system for a hand-hygiene monitor may comprise ahand-hygiene monitor including an accelerometer to detect vibrationwithin a first range, a microphone to detect sound within a secondrange, and a transmit element to transmit data detected by theaccelerometer and the microphone. The system may further comprise aprocessor configured to receive the data from the transmit element anddetermine whether a person washed their hands by analyzing data from theaccelerometer and the microphone using a machine learning model.

Alternatively or additionally to any of the examples above, in anotherexample, data from one or more other sensors or data from a radar may beused by the processor to determine whether the person washed theirhands.

Alternatively or additionally to any of the examples above, in anotherexample, the processor may determine a sound of at least one of: a handdryer blowing, the person drying their hands, a paper towel dispensing,soap dispensing, or a faucet running.

Alternatively or additionally to any of the examples above, in anotherexample, an identity of the person may be determined using a trackingdevice.

Alternatively or additionally to any of the examples above, in anotherexample, the tracking device may be a vector or real-time locationsystem (RTLS).

Alternatively or additionally to any of the examples above, in anotherexample, the tracking device may be included in an identification card.

Alternatively or additionally to any of the examples above, in anotherexample, the processor may be included in a cloud server.

Alternatively or additionally to any of the examples above, in anotherexample, the machine learning model may be a support vector machine, adeep neural network, or a multi-way support vector machine.

In another example, a system for a hand-hygiene monitor may comprise ahand-hygiene monitor including an accelerometer to detect vibration of afaucet, a microphone to detect sound of hand washing, and a radar todetect a presence of a person within a particular proximity of thefaucet. The system may further comprise a processor configured toreceive the data from the transmit element and determine whether theperson washed their hands by analyzing data from the accelerometer, themicrophone, and the radar.

Alternatively or additionally to any of the examples above, in anotherexample, the radar may be a pulse-doppler radar.

Alternatively or additionally to any of the examples above, in anotherexample, the radar may be a frequency-modulated continuous-wave radar.

Those skilled in the art will recognize that the present disclosure maybe manifested in a variety of forms other than the specific embodimentsdescribed and contemplated herein. Accordingly, departure in form anddetail may be made without departing from the scope and spirit of thepresent disclosure as described in the appended claims.

What is claimed is:
 1. A system for monitoring compliance with apredetermined hand-hygiene procedure, comprising: a plurality of sensorspositioned adjacent a hand washing station, wherein each of theplurality of sensors is free from imaging pixels that form a visuallyperceptible image, each of the plurality of sensors is configured toprovide a corresponding sensor output signal that is indicative ofwhether one or more predetermined actions associated with thepredetermined hand-hygiene procedure has been performed or not; acontroller configured to fuse the sensor output signals from each of twoor more of the plurality of sensors to produce a fused sensor output,and to determine using the fused sensor output whether at least one ofthe predetermined actions associated with the predetermined hand-hygieneprocedure has been performed in compliance with one or more compliancecriteria; and the controller further configured to output a notificationwhen the controller has determined that one or more of the predeterminedactions associated with the predetermined hand-hygiene procedure has notbeen performed in compliance with one or more corresponding compliancecriteria and/or when the controller has determined that one or more ofthe predetermined actions associated with the predetermined hand-hygieneprocedure has been performed in compliance with one or morecorresponding compliance criteria.
 2. The system of claim 1, wherein thepredetermined hand-hygiene procedure includes a hand washing procedureand the one or more predetermined actions includes hand scrubbing for atleast a dwell time.
 3. The system of claim 2, wherein the one or morepredetermined actions includes dispensing soap from a soap dispenser. 4.The system of claim 2, wherein the one or more predetermined actionsincludes having water flow at the hand washing station.
 5. The system ofclaim 2, wherein the one or more predetermined actions includes handdrying.
 6. The system of claim 1, wherein fusing the sensor outputsignals from each of two or more of the plurality of sensors comprisesassigning different weights to at least two of the sensor output signalsfrom each of two or more of the plurality of sensors.
 7. The system ofclaim 6, wherein the different weights are assigned by a machinelearning model.
 8. The system of claim 1, wherein the controller isconfigured to obtain an identity of a person at the hand washingstation, and to set one or more of the compliance criteria based atleast in part on the identity of the person.
 9. The system of claim 1,wherein the plurality of sensors comprise an accelerometer and/or amicrophone.
 10. The system of claim 1, wherein the plurality of sensorscomprise a plurality of thermal imaging sensors.
 11. The system of claim1, wherein the plurality of sensors comprises one or more accelerometersand/or one or more microphones, and one or more of a light sensor, aradar sensor, a humidity sensor, a temperature sensor, a motiondetector, and/or a magnetometer.
 12. The system of claim 1, wherein theplurality of sensors comprise an accelerometer and a microphone, andwherein the controller fuses the sensor output signals from theaccelerometer and the microphone to result in the fused sensor output.13. The system of claim 1, wherein the plurality of sensors comprise aradar.
 14. A method for monitoring hand-hygiene, the method comprising:determining whether a person has performed a predetermined hand-hygieneprocedure in compliance with one or more compliance criteria using twoor more sensor outputs from two or more sensors, wherein each of theplurality of sensors is configured to provide a corresponding sensoroutput that is indicative of whether one or more actions associated withthe predetermined hand-hygiene procedure has been performed; fusing twoor more of the sensor outputs from two or more of the sensors to producea fused sensor output, and using the fused sensor output to determinewhether the person has performed at least one of the actions associatedwith the predetermined hand-hygiene procedure in compliance with one ormore of the compliance criteria; and reporting whether the person hasperformed the predetermined hand-hygiene procedure in compliance withthe one or more compliance criteria.
 15. The method of claim 14, whereinthe predetermined hand-hygiene procedure includes a plurality ofactions, wherein the method further comprises: determining whether eachof the plurality of actions associated with the predeterminedhand-hygiene procedure have been performed in compliance with one ormore compliance criteria; and reporting which of the plurality ofactions associated with the predetermined hand-hygiene procedure havenot been performed in compliance with one or more compliance criteriaand/or which of the plurality of actions associated with thepredetermined hand-hygiene procedure have been performed in compliancewith one or more compliance criteria.
 16. The method of claim 14,wherein the one or more actions associated with the predeterminedhand-hygiene procedure comprises hand scrubbing for at least a dwelltime.
 17. The method of claim 14, wherein the one or more actionsincludes dispensing soap from a soap dispenser.
 18. A method formonitoring hand-hygiene, the method comprising: obtaining an identity ofa person at a hand washing station; setting one or more compliancecriteria based at least in part on the identity of the person;determining whether the person has performed a predeterminedhand-hygiene procedure in compliance with the one or more compliancecriteria set for the person using two or more sensor outputs from two ormore sensors, wherein each of the plurality of sensors is configured toprovide a corresponding sensor output that is indicative of whether oneor more actions associated with the predetermined hand-hygiene procedurehas been performed; fusing two or more of the sensor outputs from two ormore of the sensors to produce a fused sensor output, and using thefused sensor output to determine whether the person has performed atleast one of the actions associated with the predetermined hand-hygieneprocedure in compliance with one or more of the compliance criteria setfor the person; and reporting whether the person has performed thepredetermined hand-hygiene procedure in compliance with the one or morecompliance criteria.
 19. The method of claim 18, wherein thepredetermined hand-hygiene procedure includes a plurality of actions,wherein the method further comprises: determining whether each of theplurality of actions associated with the predetermined hand-hygieneprocedure have been performed by the person in compliance with one ormore of the compliance criteria set for the person; and reporting whichof the plurality of actions associated with the predeterminedhand-hygiene procedure have not been performed by the person incompliance with the one or more compliance criteria set for the personand/or which of the plurality of actions associated with thepredetermined hand-hygiene procedure have been performed by the personin compliance with the one or more compliance criteria set for theperson.
 20. The method of claim 18, wherein the one or more actionsassociated with the predetermined hand-hygiene procedure comprises oneor more of: hand scrubbing for at least a dwell time; and dispensingsoap from a soap dispenser.